Introduction: Gastric NENs are increasingly being diagnosed at endoscopy. The majority of these are type 1 gastric NEN. However, around 1020% can be type 3 or type 4 Gastric NENs.
Methods: A retrospective review performed of 54 patients with gastric NENs referred to a tertiary centre during 2014 to 2019.
Results: Of the 54 cases referred, 45 were type 1 gastric NENs and the 9 were type 3 Gastric NENs. Of the 45 type 1 gastric NENs: 2 patients had locally advanced/metastatic disease at diagnosis, the other 43 had localised disease. Of the 9 patients with type 3 gastric NETs 4 were grade 1 WDNET with Ki67 <2%; 2 cases were grade 2 well differentiated NETs and 1 grade 3 WDNEC and 2 poorly differentiated NEC grade 3. Over the follow up period none of the 45 type 1 gastric NETS developed gastric adenocarcinoma. 5 patients required endoscopic resection of lesions > 1 cm during the period of follow up. There were no perforations or complications post EMR or ESD of these lesions. 2 patients underwent sub-total gastrectomy, lymphadenectomy for locally advanced type 1 gastric NENs, 1 patient had liver metastases resected as well. Of the type 3 gastric NENs, 4/9 patients underwent curative surgical resections and 1 underwent palliative surgical resections. 2 endoscopic resections and 2 underwent palliative chemotherapy.
|Average Age||Average Length of diagnosis||Type||Distant Mets||Management||Mortality|
|G3 I and II||51||3.6 years||4 G3 type 1||0||2 EMR 2 wedge resection||4 alive disease free|
|G3 and advanced||67||2.6 years||2 G2 NET, 1 G3 NET and 2 NEC||3||2 curative surgery, 1 palliative surgery, 1 palliative chemo and 1 no treatment||1 died from the disease, 2 have active disease, 2 alive disease free|
Conclusion: The majority of gastric NENs are type 1. Around 10% of patients require endoscopic resection at some point during surveillance. The histological characteristics of type 3 gastric NENs are diverse and the well differentiated low grade tumours can be managed with endoscopic or limited surgical resection.
02 Dec 2019
UK and Ireland Neuroendocrine Tumour Society